Transcript AEMT: Planning for Success

DESIGNING YOUR AEMT
COURSE FOR SUCCESS
RICHARD BELLE, BS, NREMT-P
BACKGROUND
• 51% initial National Registry pass rate
• Much of what is being missed is EMT content and AHA
guidelines
• AEMT is based on assumption that students are EMTs; not
EMT-Bs
• Cannot assume either EMT-B or EMT competence
• AEMT differs greatly from EMT I-85 and EMT I-99
BACKGROUND
• NEMSES replaced NSC
• Some content changes
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Depth and breadth of A&P
Pathophysiology of hypoxia and shock
Additional medical topics
• No DOT objectives
• No detailed content outlines
BOTTOM LINE
AEMT is NOT just EMT-plus-skills
AEMT cannot be retrofitted onto EMT-I
structure
Requires planning courses anew
COURSES HAVE TWO
GOALS
• Students will learn content
• Students will learn how to use
content (A Clinical Reasoning
Approach)
HOW ARE THE GOALS
ACHIEVED?
• Rethinking course structure and
content
• Changed teaching/learning
philosophy and approach
OVERVIEW
• Why are we not aligning with what is
on the NREMT exam?
• What is new with AEMT?
• What resources are there to support
an AEMT course?
• What are effective approaches to
AEMT course design and
implementation?
NREMT EXAMS
• Additional content, time constraints
and current teaching and testing
approaches create focus on
learning content
• NREMT exams do not focus on
content, they focus on how to use
content
NREMT EXAM
The National Registry’s take:
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NR values AEMT
51% first-time pass rate
Inadequate focus on Practice Analysis outcomes
EMT-I/AEMT level has always been problematic
Significant numbers of questions missed are at EMT-level and
on AHA guidelines
NREMT EXAM
NEMSES
NR PRACTICE
ANALYSIS
Source of curriculum
Source of test items
Top-down
Bottom-up
Industry leaders
Practicing providers
Evidence-based
Perception of what is
done on the job and
the frequency and
criticality of each
task
Expert writing teams
NREMT EXAM
WHAT’S NEW IN AEMT
• EMT-B: 120 hours
• EMT: 150 to 190 hours
• AEMT: EMT + 150 to 250 hours
WHAT’S NEW IN AEMT
Content
• Must integrate EMT and AEMT material, not treat AEMT as an
“add-on”.
• NASEMSO Gap Analysis
• EMT-B—EMT
• EMT-I 85 and EMT-I 99—AEMT
WHAT’S NEW IN AEMT
New material and increased breadth and depth of material:
• All preparatory topics, especially evidence-based decisionmaking, patient safety and preventing errors
• Public health
• Medical terminology
• Anatomy and physiology, especially ventilation, respiration,
and perfusion
• Pathophysiology, especially hypoxia and hypoperfusion
• Pharmacology
• Medical emergencies
• Special patient populations
RESOURCES
• NEMSES-based texts:
• Still have objectives
• Have more course support than ever before
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Lesson plans
Slides
E-text
MyBradyLab
Workbook
RESOURCES
• Our situation departs from the typical situation of higher
education/health sciences education
• Even at the curriculum level, you are not starting from
scratch:
• NEMSES
• NEMSES-based textbooks
• NEMSES-based textbook supplements, support, assets
RESOURCES
• AEMT text is designed according to effective course
structure for a particular course that is similar wherever it
is taught
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Content
Pedagogical structure
Student support
Instructor support
COURSE PLANNING
• Tasks to be completed:
• Develop a course schedule according to your particular
situation
• Think less about “covering content” than about total
learning time
• Build the course to:
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Encourage active learning
Be learner-centered
Promote self-directed learning
(NOT SO NEW) AREAS OF
CHALLENGE
Time
Teaching
Methods
Student
Characteristics
Outcomes:
Certification
Exam & OTJ
Performance
CHALLENGE AREA #1:
STUDENT CHARACTERISTICS
• Ability and knowledge
• Academic skills
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Understanding the value of preparing for class
Reading for meaning
Taking notes
Reviewing & integrating information
Test-taking
CHALLENGE AREA #1:
STUDENT CHARACTERISTICS
• We have accepted and adapted to low-expectations for our
students.
• “My students can’t read.”
• “My students don’t read.”
• “My students don’t have good study skills.”
• Why should they, if there aren’t any consequences?
• Reading and reading comprehension are bona fide
professional requirements. If students aren’t competent,
they aren’t ready for the class.
CHALLENGE AREA #2:
TIME
Why do we need time?
• Learning is incremental
• Cannot rewire human brain
• Even the best learn only what it takes to answer
test questions
• Recognize and solve clinical problems
CHALLENGE AREA #2:
TIME
Acceptable outcomes require time commitment
Students and instructors
• 3:1 study-to-class ratio
• 8 hours a day, 5 days a week requires 160
hours in a week engaged in teaching/learning
activity
CHALLENGE AREA #2:
TIME
Instructors:
• Lots of info in little time
• Inadequate prep time
Students:
• Lots of info in little time
• Inadequate learning time between in-class
sessions
CHALLENGE AREA #2:
TIME
• Decisions:
• How to distribute learning outcomes
throughout the time allotted
• Think of total learning time, as opposed to inclass time
CHALLENGE AREA #3:
EFFECTIVE TEACHING
METHODS
What can we do in the time we’re allotted?
Effective methods for:
• “Delivering” content
• Teaching clinical reasoning and problemsolving
• Enhancing transfer of learning
PROBLEM SOLVING IS COGNITIVE
• That’s why we
call it critical
thinking
• Poor providers
make cognitive
mistakes
• Skills are easy
PROBLEM SOLVING IS
COGNITIVE
Why do we focus on psychomotor
skills?
• Visibility to instructor vs. inability to “see”
complexity of thought behind action
• Easy to correct mistakes
NEW PARADIGM
• Stop focusing on “covering material” in class
• Stop talking about active learning, student-centered
learning, and self-directed learning but doing things the
way they’ve always been done in EMS
• Create a course that brings about these things
• Stop thinking of yourself as a teacher; teaching puts the
focus of action on the instructor, not the student
• Think of yourself as a designer of learning opportunities
• Change the approach to student evaluation
TEACHING/LEARNING
METHODS
• Flipped classroom
• MyBradyLab
• Team-based learning
• Problem-based learning
COURSE PLANNING
• The flipped classroom places content acquisition outside
the classroom and opportunities for application inside the
classroom
• Lecture is no better for delivering content than reading,
watching videos, listening to podcasts
• Students should acquire content outside of class and
come to class prepared to use the content
• This paradigm change is pervasive throughout higher
education, including within medical schools. (Same
challenges of more information, restricted time, problems
in application)
OBJECTIVES: FROM
“KNOW” TO “DO”
“Know” objectives
• Define key terms
• Identify anatomy
• List signs and symptoms
“Do” objectives
• Given a scenario, apply understanding of assessment and
pathophysiology to identify immediate threats to life
• Given a scenario, develop hypotheses about the patient’s
problem
• Evaluate the pros and cons of a proposed treatment plan
TYPICAL TEACHING
METHODS
Instructor courses often tell us the don’ts –
what are the dos?
Active learning means cognitive engagement
ORCHESTRATE FOR
ACTIVE LEARNING
Clarity and organization
• Build understanding
• Create a foundation
• Add layers of complexity
ORCHESTRATE FOR
ACTIVE LEARNING
Provide multiple opportunities to engage with the content
through thinking exercises and collaborative conversations
ORCHESTRATE FOR
ACTIVE LEARNING
Opportunities to apply understanding and problem-solving
before being tested
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Practice tests
Low-stakes tests
Homework
Feedback
INSTRUCTIONAL
METHODS
Case studies, problem-based learning, discussions,
questions, well-organized lectures
Lectures that present information in meaningful ways
• Explaining
• Illustrating
• Comparing and contrasting
TEAM-BASED
LEARNING
Class focus: how to use key concepts
Instructors design & manage educational process
Students are held accountable
OVERALL SEQUENCE FOR EACH
UNIT
Initial Exposure Readiness Assessment
Practice Applying Concepts Unit Assessment
In Class:
Primarily Group Work
MiniLecture
based
on self
assess
ments.
Study
Basic
Concepts:
Read
Chapters
Readiness
Assessment:
Individual &
Group
Quizzes
Group
Work on
Simple
Problems:
In-Class
Activity
Group
Work on
Complex
Problems
Work on
Simple
Problems:
Homework
Work on
Complex
Problems:
Homework
Outside Class: Primarily Individual Work
Review
Review
Graded
Problem
Solving:
Exam
EXAMPLES
• Basic lesson structure:
• Out of class:
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Student reads AEMT Chapter
Takes pre-test on MyBradyLab
Uses remediation assets
Takes post-test
EXAMPLES
• Basic lesson structure:
• In-class:
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Mini lecture based on pre-test scores
Group projects for application
• Out-of-class:
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Homework
SUMMARY
AEMTs are important to the EMS community
Current issue of low NR pass rates
Significant content changes from NSC to NEMSES
Course planning has to consider NEMSES and NR Practice
Analysis
Use active learning approaches that teach problem-solving
QUESTIONS/CONTACT
INFO
Melissa Alexander: [email protected]
Richard Belle: [email protected]
Thank you!